Percutaneous renal biopsy in renal unit of Dhaka Shishu Hospital: a 7-year experience

F Ahmed1, M Hanif2, AK Ghosh3, MA Rouf4, MMU Quader5, NK Sarker6, MJ Alam7
Background: Kidney biopsy is the cornerstone in the management of different
renal parenchymal diseases. Renal biopsy can be performed by three methods:
percutaneous, open surgical and fine needle aspiration method. Among them
percutaneous renal biopsy is the most popular procedure to the pediatric nephrologist.
Objective: To see the histological lesions in those cases of Nephrotic syndrome, who
were not responding to the conventional treatment, to find out the underlying pathology
in certain cases of acute renal failure and to see the complications of renal biopsy.
Methodology: 151 children of different age groups, ranging from 6 months to 17
years underwent percutaneous renal biopsy between January 2003 to January
2010.The study was conducted in the Nephrology unit of Dhaka Shishu Hospital. In
this study 14 gauge and 16 gauge automated biopsy needle was used.
Results: Out of 151 cases renal tissue was obtained in 136 (90%) cases; among the
successful cases 86(63.2%) were boy and 50 (36.8%) were girl; male to female ratio
was 1.71:1. Of these 136 cases adequate renal tissue was found in 123 cases and in 13
cases inadequate renal tissue was found. Most common histological diagnosis was
mesangial proliferative glomerulonephritis 40 (32.5%), followed by minimal change
disease 33 (26.8%), focal segmental proliferative glomerulonephritis 24(19.5%),
crescentic glomerulonephritis 9(7.3%), sclerosing glomerulonephritis 6(4.88%), focal
segmental glomerulosclerosis 3(2.4%), acute tubular necrosis 2(1.6%), IgA nephropathy
2(1.6%), interstitial nephropathy 2(1.6%), focal proliferative necrotizing
glomerulonephritis 1( 0.81%), Infantile polycystic kidney 1( 0.81%).
Microscopic hematuria was the most common complication of renal biopsy.
Macroscopic hematuria was found in 8% cases. Pain was another accompaniment of
renal biopsy which was managed by analgesic. Retention of urine was found in some
children which was in turn due to obstruction of urethra and internal urethral meatus
by clot. There was no infection after the procedure.
Conclusion: Percutaneous renal biopsy using spring-loaded automated device is
effective and safe in the pediatric age group and complication rate is low.

Keywords: Percutaneous renal biopsy, Biopsy gun, Mesangial proliferative
glomerulonephritis, Haematuria.

Download PDF